Vascular Injuries in the Lower Limb of Athletes

Casey, Ellen; Lento, Paul; Ihm, Joseph; Rodríguez, Herón E.

doi:10.1007/978-0-387-76600-3_13

Cited by 3 publications

(6 citation statements)

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“…Non-traumatic vascular injuries of the lower limb such as: intimal hyperplasia, stenosis or kinking of iliac arteries inflexion, adductor canal syndrome or popliteal entrapment syndrome, effort induced venous thrombosis or chronic exertional compartment syndrome is a group of disorders affecting mainly young and healthy athletes, often trained professionals competing at the professional level without concomitant diseases and cardiovascular risk factors [9]. Among the group of the mentioned disorders, the adductor canal compression syndrome is most frequent in skiers and runners [10]. Our patient was not a professional sportsman but as a blue-collar worker, he is used to lifting huge amount of load, up to even few tons per day, for the last 30 years.…”

Section: Discussionmentioning

confidence: 99%

Critical limb ischemia caused by adductor canal compression syndrome — case report with the review of the literature

et al. 2018

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We report a case of a 55-year-old male who was diagnosed with the adductor canal compression syndrome -a rarely described nontraumatic disorder of the lower limb resulting from the external compression of the superficial femoral artery in the adductor canal, that may present with the symptoms ranging from intermittent exercise-induced claudication up to arterial obstruction and critical limb ischemia.

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Section: Discussionmentioning

confidence: 99%

Critical limb ischemia caused by adductor canal compression syndrome — case report with the review of the literature

et al. 2018

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“…Studies in the sports-related literature describe cases of blunt trauma in the common iliac 61 , external iliac and common femoral arteries caused by the bicycle handlebar 61,62 . Although statistical data are not available to confirm the incidence of compression of the iliac artery secondary to cycling, Lim et al 11 reported that arterial insufficiency may be responsible for 10% to 20% of the symptoms of pain and cramps resulting from claudication in professional cyclists.…”

Section: Discussionmentioning

confidence: 99%

“…The common femoral artery has also been involved in lesions in cyclists, particularly due to acute trauma in the region of the femoral trigone (Scarpa's triangle), where this artery is more exposed 35,62,66. The first case of common femoral artery lesion due to trauma with the handlebar end during forced dorsal flexion.…”

Section: Common Femoral Arterymentioning

confidence: 99%

“…Tortuosity with kinking generated by hip hyperflexion 3,9,22,[27][28][29][30]36,39,62,71 (Figure 2a, b) and artery compression due to psoas muscle and inguinal ligament hypertrophy during pedaling 3,27,29,36,39,61,71,72 are, according to the literature, the factors responsible for blood flow reductions. For this reason, the excision of this ligament is common in patients with vascular compression (e.g., external iliac and common femoral arteries) in the inguinal region 9,49,57,58,60. According to Schep 63 , artery tortuosity may be measured with an …”

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confidence: 91%

“…In young growing cyclists, lesions that are not diagnosed and treated may progress to chronic ischemia, compromising blood flow in the proximal growth plate of the femur, resulting in differences in length of lower limbs and changes in gait 31 . Surgical procedures should be a priority in cyclists with evident signs of ischemia, because the interruption of blood flow for more than 4 hours may lead to irreversible neurological damage and muscle necrosis 62 . Although arterial lesions due to handlebar trauma in the inguinal region are uncommon, they should be recognized by first aid professionals 35 , because the lack of knowledge of this trauma mechanism is responsible for delayed diagnoses in four out of six cases reported in the literature 31 .…”

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Lower limb vascular dysfunction in cyclists

2013

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Sports-related vascular insufficiency affecting the lower limbs is uncommon, and early signs and symptoms can be confused with musculoskeletal injuries. This is also the case among professional cyclists, who are always at the threshold between endurance and excess training. The aim of this review was to analyze the occurrence of vascular disorders in the lower limbs of cyclists and to discuss possible etiologies. Eighty-five texts, including papers and books, published from 1950 to 2012, were used. According to the literature reviewed, some cyclists receive a late diagnosis of vascular dysfunction due to a lack of familiarity of the medical team with this type of dysfunction. Data revealed that a reduced blood flow in the external iliac artery, especially on the left, is much more common than in the femoral and popliteal arteries, and that vascular impairment is responsible for the occurrence of early fatigue and reduced performance in cycling.Keywords: cycling; peripheral arteriopathy; blood flow; stenosis. ResumoO desenvolvimento de insuficiência vascular em membros inferiores relacionada à prática esportiva é incomum e no início do surgimento dos sinais e sintomas frequentemente pode ser confundida com lesão musculoesquelética, a exemplo de casos relatados em ciclistas profissionais, por estarem sempre no limiar entre o treinamento em nível máximo e o excesso de treinamento. O objetivo desta revisão de literatura foi analisar a ocorrência de disfunções vasculares em membros inferiores em ciclistas e as possíveis etiologias. Oitenta e cinco textos, entre artigos e livros publicados de 1950 a 2012 foram utilizados. Segundo a literatura, alguns ciclistas têm o diagnóstico de disfunção vascular realizado tardiamente devido à falta da familiaridade da equipe médica com esta modalidade de disfunção. Os resultados da pesquisa revelaram que a redução do fluxo sanguíneo na artéria ilíaca externa, em especial a esquerda, é bem mais comum que a da artéria femoral e poplítea, e que o comprometimento vascular é responsável pela ocorrência de fadiga precoce e redução do desempenho no ciclismo.Palavras-chave: ciclismo; arteriopatia periférica; fluxo sanguíneo; estenose.

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Vascular Trauma in the Amazon Region: A Two Years Cases Review From a Single Institution

Góes¹,

Rodrigues²,

Braga³

et al. 2014

Health

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Introduction: Vascular injuries are among the main mechanisms of death in trauma. In Brazil, the general surgeon is in charge of emergencies procedures in most hospitals, but many times these surgeons are not familiarized with more complex vascular surgical techniques that often require a vascular surgeon. Pará State is the most populated one in the Brazilian Amazon region and a single hospital with vascular surgeons permanently on call is available. Objectives: To evaluate demographic data on vascular trauma victims; to establish the mechanism, anatomic location, injury pattern and surgical techniques used to manage the vascular lesions treated at the Metropolitan Emergency Hospital; to ascertain associated non-vascular injuries and victim's clinical outcome. Methods: Medical records retrospective analysis of patients treated for vascular injuries from February 2011 to February 2013 at the institution in case. All arterial and venous injuries were analyzed. Patients who were not operated by the vascular surgery team, iatrogenic injuries and those who underwent primary or sustained traumatic amputation were excluded. Results: 173 cases; 95.95% were male; 54.90% were between 25 and 49 years; penetrating trauma mechanisms were found in 88.44%; lower limb was the most affected topography (41.50%); the most injured vessels were the superficial femoral and ulnar arteries (in 15.75% of cases each) and the superficial femoral vein (17.77%); autologous vein graft was the most performed technique for arterial repair (36.57%) and ligature was performed in 85.00% of venous trauma; amputation rate was 15.60% and mortality rate was 6.35%. Conclusions: Vascular injuries occurred predominantly in men from 24 to 49 years old; penetrating mechanisms were most frequent; lower limb was the most affected topography; the most frequently injured vessels were the ulnar and superficial femoral arteries and the superficial femoral vein; complete vessel transection was the most common injury pattern; arterial trauma was most frequently treated by autologous venous graft

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Vascular Injuries in the Lower Limb of Athletes

Cited by 3 publications

References 55 publications

Critical limb ischemia caused by adductor canal compression syndrome — case report with the review of the literature

Critical limb ischemia caused by adductor canal compression syndrome — case report with the review of the literature

Lower limb vascular dysfunction in cyclists

Vascular Trauma in the Amazon Region: A Two Years Cases Review From a Single Institution

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